Apparatus for positioning a medical object and method for providing a correction specification

ABSTRACT

An apparatus for positioning a medical object includes a moving apparatus for robotically moving the medical object. The medical object includes a predefined section. The predefined section is at least partially arranged in an examination object. The apparatus is configured to receive a control specification. The moving apparatus is configured to position the predefined section based on the control specification. The apparatus is further configured to receive positioning information on the predefined section and determine a degree of deviation. The degree of deviation describes a deviation between the control specification and the positioning information. The apparatus is configured to determine a correction specification for minimizing the deviation based on the degree of deviation. The moving apparatus is further configured to reposition the predefined section based on the correction specification.

This application claims the benefit of German Patent Application NumberDE 10 2020 212 000.5, filed on Sep. 24, 2020, which is herebyincorporated by reference in its entirety.

BACKGROUND

The present embodiments relate to an apparatus for positioning a medicalobject, a system, a method for providing a correction specification, amethod for providing a trained function, and a computer program product.

Interventional medical procedures in or via a vascular system of anexamination object frequently require the (e.g., percutaneous)introduction of a, for example, elongated medical object into thevascular system. Further, successful diagnosis and/or treatment oftenrequires at least part of the medical object to be guided toward atarget region to be treated in the vascular system.

Movement of the medical object (e.g., translation and/or rotation) mayresult in meandering and/or spiraling of the medical object in thevascular system. This may cause a delayed reaction of a distal sectionof the medical object to a movement applied to a distal section (e.g.,by an operator). Further, this may result in a difference in lengthand/or difference in angle between a prespecified target positioning andthe actual positioning of the distal section. To compensate thisdifference in length and/or difference in angle, the medical object isoften moved by the medical operator (e.g., manually) under regular X-rayfluoroscopy control. Herein, one drawback is the high X-ray exposure ofthe medical operator and the examination object. Further, withoutprecise knowledge of the spatial course of the medical object in thevascular system (e.g., a manifestation of meandering and/or spiraling),positioning of the distal section is frequently subject to errors.

SUMMARY AND DESCRIPTION

The scope of the present invention is defined solely by the appendedclaims and is not affected to any degree by the statements within thissummary.

The present embodiments may obviate one or more of the drawbacks orlimitations in the related art. For example, improved positioning of amedical object is provided.

In a first aspect, an apparatus for positioning a medical object isprovided. Herein, the apparatus includes a moving apparatus forrobotically moving the medical object. Further, the medical objectincludes a predefined section. The predefined section is at leastpartially arranged in an examination object. Further, the apparatus isembodied to receive a control specification. The moving apparatus isfurther embodied to position the predefined section based on the controlspecification. The apparatus is further embodied to receive positioninginformation on the predefined section. Further, the apparatus isembodied to determine a degree of deviation. Herein, the degree ofdeviation describes a deviation between the control specification andthe positioning information. Further, the apparatus is embodied todetermine a correction specification for minimizing the deviation basedon the degree of deviation. The moving apparatus is further embodied toreposition the predefined section based on the correction specification.

Herein, the medical object may, for example, be embodied as a surgicalinstrument and/or diagnostic instrument. For example, the medical objectmay be elongated and/or flexible. The medical object may, for example,be embodied as a catheter and/or endoscope and/or guide wire. Thepredefined section of the medical object may describe a spatial (e.g.,distal) section of the medical object (e.g., an end and/or tip of themedical object).

The apparatus may further include a providing unit embodied to controlthe apparatus and/or the components thereof (e.g., the movingapparatus).

Further, the moving apparatus may be a robotic apparatus embodied forremote manipulation of the medical object (e.g., a catheter robot). Inone embodiment, the moving apparatus is arranged outside the examinationobject. Further, the moving apparatus may include a fastening element(e.g., movable and/or mobile). Further, the moving apparatus may includea cassette element embodied to record at least part of the medicalobject. Further, the moving apparatus may include a moving elementfastened to the fastening element (e.g., a stand and/or robot arm).Further, the fastening element may be embodied to fasten the movingelement to a patient support apparatus. Further, the moving element mayinclude at least one actuator element (e.g., an electric motor), wherethe providing unit is embodied to control the actuator element. In oneembodiment, the cassette element may be coupled (e.g., mechanicallyand/or electromagnetically and/or pneumatically) to the moving element(e.g., the at least one actuator element). Herein, the cassette elementmay further include at least one transferring element that may be movedby the coupling between the cassette element and the moving element(e.g., the at least one actuator element). For example, the at least onetransferring element may be motion-coupled to the at least one actuatorelement. In one embodiment, the transferring element is embodied totransfer a movement of the actuator element to the medical object suchthat the medical object is moved along a longitudinal extensiondirection of the medical object and/or the medical object is rotatedabout the longitudinal extension direction. The at least onetransferring element may, for example, include a roll and/or rollerand/or diaphragm and/or shear plate.

In one embodiment, the moving element may include a plurality ofactuator elements (e.g., independently controllable actuator elements).Further, the cassette element may include a plurality of transferringelements (e.g., at least one motion-coupled transferring element) foreach of the actuator elements. This may enable movement (e.g.,independent and/or simultaneous movement) of the medical object alongdifferent degrees of freedom of movement.

The apparatus (e.g., the providing unit) may be embodied to receive thecontrol specification. The reception of the control specification may,for example, include capturing and/or reading a computer-readable datamemory and/or reception from a data memory unit (e.g., a database).Further, the control specification may be provided by an input unit forcapturing input from an operator. The control specification may includeat least one command for control (e.g., step-by-step control) of themoving apparatus. For example, the control specification may include atleast one command (e.g., a temporal sequence of commands) for specifyingtranslation and/or rotation (e.g., simultaneous translation androtation) of the medical object (e.g., the predefined section) by themoving apparatus. In one embodiment, the providing unit may be embodiedto translate the control specification and to control the movingapparatus based thereon. Further, the moving apparatus may be embodiedto position the medical object based on the control specification (e.g.,to move the medical object in a translational and/or rotational manner).

Alternatively or additionally, the control specification may include aspecification regarding spatial target positioning to be achieved by thepredefined section (e.g., a spatial position and/or alignment and/orpose to be achieved) in the examination object. Herein, the providingunit may be embodied to translate the control specification (e.g., basedon a map and/or a model of the examination object) into at least onecommand for controlling the moving apparatus and to control thisthereon. For example, the providing unit may be embodied to control themoving apparatus based on the map and/or the model of the examinationobject and the control specification such that the predefined section ispositioned. For example, the providing unit may be embodied to navigatethe predefined section in the examination object using the controlspecification and the moving apparatus. The examination object may, forexample, be a human or animal patient and/or a phantom (e.g., a vascularphantom) and/or a cadaver. For example, the examination object mayinclude a hollow organ (e.g., a vascular section), in which the medicalobject (e.g., the predefined section) is at least partially arranged.

In one embodiment, the positioning of the predefined section may includea movement (e.g., a translation and/or rotation) of the medical object(e.g., the predefined section) with respect to the moving apparatus(e.g., with respect to the examination object). In one embodiment, afterpositioning, the predefined section may include an initial positioning(e.g., an initial spatial position and/or alignment and/or pose) in theexamination object. Further, the moving apparatus may be embodied todeform the predefined section of the medical object in a defined manner(e.g., using a cable pull) within the medical object. In one embodiment,the apparatus (e.g., the moving apparatus) may be embodied to positionthe predefined section of the medical object in the initial positioningin the examination object based on the control specification. Forexample, the control specification may include information with respectto a relative movement of the medical object (e.g., the predefinedsection) for positioning the predefined section in the initialpositioning with respect to the moving apparatus.

Further, the apparatus may be embodied to receive the positioninginformation on the predefined section. The reception of the positioninginformation may, for example, include capturing and/or reading acomputer-readable data memory and/or reception from a data memory unit(e.g., a database). Further, the positioning information may be receivedby a capturing unit for capturing a positioning (e.g., instantaneouspositioning) of the predefined section. The positioning information mayinclude information on a spatial position and/or alignment and/or pose(e.g. instantaneous) of the predefined section in the examinationobject.

Further, the apparatus may be embodied to determine the degree ofdeviation. The degree of deviation describes a deviation between thecontrol specification and the positioning information. For example, thedegree of deviation may describe a difference between a spatial targetpositioning of the predefined section prespecified by the controlspecification and the actual spatial positioning of the predefinedsection (e.g., the initial positioning) described by the positioninginformation. Further, the degree of deviation may include a differencein length (e.g., shortening or lengthening) and/or a difference in anglebetween the spatial target positioning of the predefined sectionprespecified by the control specification and the actual positioningdescribed by the positioning information.

If the control specification specifies the spatial positioning of thepredefined section with respect to the moving apparatus, the positioninginformation may describe the spatial positioning (e.g., instantaneous)of the predefined section in, for example, an analogous manner withrespect to the moving apparatus. The spatial positioning of thepredefined section may, for example, be described by a length dimensionalong the longitudinal extension direction of the medical object and/oran angle of the medical object relative to the moving apparatus.

Alternatively or additionally, the control specification may specify thespatial positioning of the predefined section with respect to theexamination object (e.g., in a patient coordinate system). Here, thepositioning information may describe the information on the spatialpositioning (e.g., instantaneous) of the predefined section in the samepatient coordinate system. The degree of deviation may describe adeviation between the spatial target positioning of the predefinedsection prespecified by the control specification and the actual spatialpositioning described by the positioning information in the patientcoordinate system. The deviation between the spatial target positioningof the predefined section prespecified by the control specification andthe actual spatial positioning described by the positioning information(e.g., the initial positioning) may be caused by meandering and/orspiraling of the medical object in the hollow organ. Herein, themeandering of the medical object, for example, describes a sinuouscourse of the medical object, where the sinuous course follows acurvature (e.g., a curve) of the hollow organ mostly on a curve outerside of the hollow organ. Further, rotation of the medical object by themoving apparatus may result in spiraling of the medical object. Herein,the spatial course of the medical object in the hollow organ may includean at least partially spiral-shaped (e.g., spatially twisted) course.

Further, the apparatus may be embodied to determine a correctionspecification for minimizing the deviation based on the degree ofdeviation. Herein, the correction specification may (e.g., analogouslyto the control specification) include at least one command for control(e.g., step-by-step control) of the moving apparatus. For example, thecorrection specification may include at least one command (e.g., atemporal sequence of commands) for specifying a translation and/orrotation (e.g., simultaneous translation and rotation) of the medicalobject (e.g., the predefined section) by the moving apparatus. In oneembodiment, the apparatus may be embodied to determine the correctionspecification such that the deviation between the control specificationand the positioning information is minimized. For this purpose, thecorrection specification may include the at least one command forspecifying the repositioning of the medical object (e.g., the predefinedsection). In one embodiment, the moving apparatus may be embodied toreposition the predefined section based on the correction specificationfrom the initial positioning toward the target positioning prespecifiedby the control specification.

The apparatus may be embodied to repeatedly determine the degree ofdeviation and/or the correction specification in the event of a changein the positioning information and/or control specification. Further,the moving apparatus may be embodied for repeated repositioning of thepredefined section in the event of a changed correction specification.

This enables particularly precise positioning and/or movement of amedical object (e.g., the predefined section) in the examination object.This may reduce injuries to the examination object. Further, the controlof the apparatus (e.g., the moving apparatus) may be improved based onthe correction specification. Further, the correction specification maybe used for improved path planning for positioning the medical object ina further positioning. For example, the proposed apparatus maycompensate and correct incorrect positioning of the predefined section(e.g., due to meandering and/or spiraling) of the medical object in theexamination object (e.g., in the hollow organ).

In a further embodiment of the proposed apparatus, the controlspecification may include a specification for spatial positioning (e.g.,a length dimension along the longitudinal extension direction of themedical object and/or an angle of the medical object) and/or a relativemovement of the medical object (e.g., the predefined section) withrespect to the moving apparatus. Further, the positioning informationmay include information on the spatial positioning of the predefinedsection (e.g., the length dimension along the longitudinal extensiondirection of the medical object and/or the angle of the medical object)with respect to the moving apparatus.

In one embodiment, the control specification may specify the spatialpositioning of the medical object (e.g., the predefined section) withrespect to the moving apparatus. Herein, the specification for spatialpositioning of the medical object (e.g., the predefined section) mayinclude a specification for the length dimension along the longitudinalextension direction of the medical object and/or the angle of themedical object relative to the moving apparatus.

Alternatively or additionally, the control specification may include thespecification for the relative movement of the medical object (e.g., thepredefined section) with respect to the moving apparatus (e.g., forpositioning the predefined section in the initial positioning). Herein,the relative movement may describe a movement (e.g., a translationand/or rotation) of the medical object (e.g., the predefined section)with respect to the moving apparatus.

Further, the positioning information may include information on thespatial positioning (e.g., instantaneous) of the predefined section withrespect to the moving apparatus. Herein, the spatial positioning of thepredefined section may, for example, be described by the lengthdimension along the longitudinal extension direction of the medicalobject and/or the angle of the medical object relative to the movingapparatus.

In one embodiment, the degree of deviation may describe a differencebetween the spatial positioning prespecified by the controlspecification and/or the relative movement of the medical object (e.g.,the predefined section) with respect to the moving apparatus and thespatial positioning described by the positioning information (e.g., theactual spatial positioning of the predefined section with respect to themoving apparatus). Herein, the degree of deviation may describe adifference in length (e.g., shortening or lengthening) and/or adifference in angle.

In a further embodiment of the proposed apparatus, the apparatus mayfurther be embodied to determine the degree of deviation in dependenceon a direction of movement along which the moving apparatus is embodiedto position the predefined section.

The at least partial arrangement of the medical object (e.g., elongatedmedical object) in the examination object (e.g., in a hollow organ ofthe examination object) may result in meandering and/or spiraling of themedical object. Herein, this meandering and/or spiraling is oftendependent on a direction of movement (e.g., translational and/orrotational) for positioning the predefined section.

Herein, the meandering and/or spiraling may be intensified (e.g.,maximized) if the predefined section is positioned along a translationaldirection of movement facing away from the moving apparatus. Incontrast, the meandering and/or spiraling may be reduced (e.g.,minimized) if the predefined section is positioned along a translationaldirection of movement facing the moving apparatus. Hence, the deviationbetween the control specification and the positioning information whenthe predefined section is positioned along the translational directionof movement facing away from and/or facing the moving apparatus may havea different sign in each case. Further, a manifestation and/or windingdirection of the spiraling may be dependent on a rotational direction ofmovement for positioning the predefined section.

In one embodiment, the apparatus may be embodied to determine the degreeof deviation in dependence on the at least one direction of movement(e.g., along a number of different directions of movement), along whichthe moving apparatus is embodied to position the predefined section.Herein, the apparatus may further be embodied to determine in each casea correction specification for the at least one direction of movementbased on the respective degree of deviation for minimizing theassociated deviation and to provide the associated deviation to themoving apparatus.

This may enable particularly precise and at the same time efficientcorrection of incorrect positioning of the predefined section independence on the at least one direction of movement for positioning thepredefined section.

In a further embodiment of the proposed apparatus, the apparatus mayfurther be embodied to receive a data set including a map and/or a modelof the examination object. Herein, the apparatus may moreover beembodied to additionally determine the degree of deviation based on thedata set.

The reception of the data set (e.g., the map and/or the model) may, forexample, include capturing and/or reading a computer-readable datamemory and/or reception from a data memory unit (e.g., a database).Further, the data set may be provided by a providing unit of a medicalimaging device for recording and/or providing the data set. The medicalimaging device may, for example, include a magnetic resonance imagingsystem (MRI) and/or a computed tomography system (CT) and/or a medicalX-ray device (e.g., a medical C-arm X-ray device) and/or an ultrasounddevice and/or a positron emission tomography system (PET).

The data set may include a 2D and/or 3D map (e.g., time resolved) of theexamination object (e.g., the hollow organ). For example, the data setmay include a contrasted and/or segmented map of the examination object(e.g., the hollow organ). Further, the data set may map the examinationobject preoperatively and/or intraoperatively. Alternatively oradditionally, the data set may include a 2D and/or 3D model (e.g., acenterline model and/or a volume model, such as a volume mesh model) ofthe examination object (e.g., the hollow organ). The data set may beregistered with the patient coordinate system and/or with respect to themoving apparatus.

In one embodiment, the apparatus may be embodied to map the initialpositioning of the predefined section and/or a spatial course of themedical object in the examination object based on the controlspecification in the data set. For example, the apparatus may beembodied to determine (e.g., to simulate) the initial positioning of thepredefined section and/or the spatial course of the medical object basedon the control specification in the data set. In one embodiment, theapparatus may be embodied to simulate and/or map the meandering and/orspiraling of the medical object in the data set when the predefinedsection is positioned. For this purpose, the apparatus may further beembodied to receive a material parameter and/or operating parameter ofthe medical object and/or a physiological parameter of the examinationobject. The reception of the material parameter and/or operatingparameter of the medical object and/or the physiological parameter ofthe examination object may, for example, include capturing and/orreading a computer-readable data memory and/or reception from a datamemory unit (e.g., a database). Further, the operating parameter may beprovided by the moving apparatus and/or the medical object. Further, thephysiological parameter of the examination object may be provided by asensor unit for capturing the physiological parameter. The sensor unitmay, for example, include a respiratory sensor and/or a pulse sensorand/or a motion sensor. The material parameter may, for example,describe a deformability (e.g., extensibility and/or torsional strengthand/or flexibility) of the medical object. Further, the operatingparameter may describe information on an operating state (e.g.,instantaneous) of the medical object. For example, the operatingparameter may include information on a spatial pose of the medicalobject. Further, the physiological parameter may include information ona physiological state and/or a temporal course of the physiologicalstate of the examination object (e.g., during the positioning of thepredefined section). The physiological parameter may, for example,include a respiratory signal and/or a pulse signal and/or a motionsignal of the examination object. In one embodiment, the apparatus maybe embodied to simulate the initial positioning of the predefinedsection and/or the spatial course of the medical object additionallybased on the material parameter and/or the operating parameter of themedical object and/or the physiological parameter of the examinationobject in the data set. This may enable the meandering and/or spiralingof the medical object in the examination object (e.g., in the holloworgan) to be simulated and/or mapped particularly precisely in the dataset.

The inclusion of the data set when determining the degree of deviationenables the spatial course (e.g., the meandering and/or spiraling) ofthe medical object in the examination object to be taken into account.For example, the data set may include information on a spatial courseand/or a spatial extent of the hollow organ, in which the medical objectis at least partially arranged (e.g., a diameter and/or across-sectional area). The apparatus may be embodied to determine thedegree of deviation particularly precisely (e.g., in dependence on thedirection of movement for positioning the predefined section)additionally based on the data set. Herein, the apparatus may further beembodied to take into account the information on the spatial courseand/or the spatial extent of the hollow organ for determining the degreeof deviation (e.g., a difference in length and/or difference in angle)in dependence on the direction of movement for positioning thepredefined section.

In a further embodiment of the proposed apparatus, the data set mayinclude a centerline model of a vascular section of the examinationobject. Herein, the predefined section may be arranged in the vascularsection. Further, the apparatus may be embodied to determine thedeviation with respect to the centerline model.

The centerline model may include at least one centerline. The centerlinedescribes the spatial course of the hollow organ (e.g., at least onevascular section of the examination object) spatially (e.g.,two-dimensionally and/or three-dimensionally). Herein, the at least onecenterline may be a midline of the hollow organ, which in each case,extends along a longitudinal extension direction of the hollow organthrough the midpoint of the cross-sectional area of the hollow organ.For example, the apparatus may be embodied to determine (e.g., tosimulate) the initial positioning of the predefined section and/or thespatial course of the medical object based on the control specificationin the centerline model.

Herein, a spatial course of the at least one centerline from an entrypoint of the medical object into the examination object to a spatialtarget positioning of the predefined section may describe a meandistance of the medical object (e.g., if the medical object were to bearranged along the centerline). When positioning the predefined sectionalong a direction (e.g., translational direction) of movement facingaway from the moving apparatus, meandering and/or spiraling of themedical object in the hollow organ may result in a lengthening of thedistance from the entry point to the target positioning compared to themean distance. Further, when the predefined section is positioned alonga direction (e.g., translational direction) of movement facing themoving apparatus, there may be a shortening of the distance from theentry point to the target positioning compared to the mean distance. Inone embodiment, the apparatus may be embodied to determine the deviation(e.g., the degree of deviation) with respect to the centerline model(e.g., the mean distance). Herein, the apparatus may further be embodiedto determine the shortening and/or lengthening of the distance from theentry point to the target positioning compared to the mean distance bydetermining (e.g., section-by-section) a spatial deviation between thespatial course of the medical object and the centerline model (e.g.,substantially perpendicular to the at least one centerline). Herein, thespatial deviation between the spatial course of the medical object andthe centerline model may be limited by the spatial extent of the holloworgan (e.g., a diameter and/or a cross-sectional area).

Further, the apparatus may be embodied to additionally determine thecorrection specification for minimizing the deviation based on thecourse of the at least one centerline. Further, the apparatus may beembodied to take account of a curvature and/or spatial extent of thehollow organ for the determination of the correction specification.

This may enable particularly precise correction of incorrect positioningof the predefined section (e.g., taking into account the spatial courseof the medical object in the hollow organ).

In a further embodiment of the proposed apparatus, the moving apparatusmay be embodied to move the medical object for positioning thepredefined section in an initial positioning along a first direction ofmovement based on the control specification. Further, the movingapparatus may be embodied to move the medical object based on a furthercontrol specification such that the predefined section starts to leavean initial positioning. Further, the apparatus may be embodied toadditionally determine the degree of deviation based on a comparison ofthe control specification with the further control specification.

Herein, the first direction of movement may substantially face toward orface away from the moving apparatus. In one embodiment, the apparatusmay be embodied to capture a deviation of the predefined section fromthe initial positioning (e.g., a change in the positioning). Forexample, the apparatus may be embodied to capture the change inpositioning of the predefined section based on the positioninginformation (e.g., a change in the positioning information).

The further control specification may, for example, include all thefeatures and properties as described in relation to the controlspecification and vice versa. Further, the moving apparatus may beembodied to move the medical object based on the further controlspecification against the first direction of movement such that apositioning (e.g., instantaneous) of the predefined section deviatesfrom the initial positioning. For example, the moving apparatus may beembodied to move the medical object according to the further controlspecification against the first direction of movement until thepredefined section starts to leave an initial positioning. Herein, thefurther control specification may include information with respect to arelative movement of the medical object (e.g., the predefined section)with respect to the moving apparatus, where the relative movementincludes a period of time of the movement of the medical object againstthe first direction of movement from the start of the movement up to apoint in time at which the predefined section starts to leave itsinitial positioning. For example, the further control specification mayinclude information regarding a spatial distance covered during therelative movement of the medical object with respect to the movingapparatus and/or an angle of rotation (e.g., up to the point in time atwhich the predefined section deviates from an initial positioning).

After the predefined section has been positioned in the initialpositioning in the examination object (e.g., the hollow organ), thespatial course of the medical object may include a lengthening (e.g.,compared to the mean distance) along a first direction of movementfacing away from the moving apparatus (e.g., due to meandering and/orspiraling of the medical object). Herein, the moving apparatus may beembodied to shorten this lengthening by moving the medical objectagainst the first direction of movement (e.g., along a direction ofmovement facing the moving apparatus). Alternatively, after thepredefined section has been positioned in the initial positioning in theexamination object (e.g., the hollow organ), the spatial course of themedical object may include a shortening (e.g., compared to the meandistance) along a first direction of movement facing the movingapparatus. Herein, the moving apparatus may be embodied to lengthen thisshortening by moving the medical object against the first direction ofmovement (e.g., along a direction of movement facing away from themoving apparatus).

The apparatus may further be embodied to additionally determine thedegree of deviation based on the comparison of the control specificationwith the further control specification. The comparison of the controlspecification with the further control specification may, for example,include a formation of a difference of the translation and/or rotationof the medical object prespecified by the respective controlspecification with respect to the moving apparatus. Herein, theapparatus may be embodied to determine the degree of deviation (e.g.,including a difference in length and/or difference in angle of themedical object) with respect to the initial positioning (e.g., betweenthe maximum shortening and maximum lengthening of the arrangement of themedical object in the hollow organ). This enables it to be providedthat, on a movement of the medical object (e.g., against the firstdirection of movement), according to a second control specification, thepredefined section follows this specification directly and withoutdelay. Further, the apparatus may be embodied to determine thecorrection specification based on the degree of deviation (e.g., basedon the further control specification).

According to a further embodiment, the apparatus may be embodied to movethe medical object repeatedly, based on the further controlspecification, in each case one after the other along two oppositedirections of movement (e.g., in an oscillatory manner). In oneembodiment, a distance of the movement (e.g., the translation and/orrotation) may in each case be the same for the opposing movements of themedical object in a repetition so that, after an oscillation, themedical object is in each case again arranged in an originalpositioning. Further, the apparatus may be embodied to increase theamplitude of the movement (e.g., the oscillation) with each repetitionof the paired opposing movement of the medical object until thepredefined section starts to leave an initial positioning. This enablesthe apparatus to be embodied to determine the degree of deviation and/orthe correction specification for the opposing directions of movementbased on the further control specification and the amplitude of themovement at the point in time of the leaving of the initial positioningof the predefined section. In one embodiment, the apparatus may furtherbe embodied to determine the degree of deviation and/or the correctionspecification by moving the medical object in an oscillatory manneralong two opposing directions of rotation and/or along two opposingdirections of translation at the initial positioning. This enables theapparatus to be embodied to ascertain and provide the correctionspecification for the different degrees of freedom of movement of themoving apparatus (e.g., the medical object) in a particularly precisemanner. Further, the oscillatory movement may provide that thepredefined section is arranged in the initial positioning after eachrepetition.

In a further embodiment of the proposed apparatus, the apparatus mayfurther be embodied to determine the degree of deviation and thecorrection specification for different initial positionings of thepredefined section in the examination object. Further, the apparatus maybe embodied to determine the correction specification for at least onefurther positioning of the predefined section in the examination objectby interpolation and/or extrapolation of the correction specificationsdetermined so far.

In one embodiment, the apparatus (e.g., the moving apparatus) may beembodied to position the predefined section of the medical object (e.g.,one after the other) at different initial positionings in theexamination object (e.g., the hollow organ). Herein, the differentinitial positionings may form a path in the examination object (e.g.,the hollow organ). For example, the moving apparatus may be embodied tomove the predefined section of the medical object along the path towardthe target positioning. Herein, the apparatus may be embodied todetermine the degree of deviation and the correction specification foreach of the different initial positionings (e.g., along the path).Moreover, the apparatus may be embodied to determine the degree ofdeviation and the correction specification for the different initialpositionings in each case according to one of the above-describedembodiments. Further, the apparatus may be embodied to determine thecorrection specification for at least one further positioning of thepredefined section (e.g., for intermediate positionings along the pathand/or for the target positioning) by interpolation and/or extrapolationof the correction specifications determined so far. For example, theapparatus may be embodied, based on the degrees of deviation andcorrection specifications determined for the different initialpositionings, to parameterize the degree of deviation and/or thecorrection specification in dependence on the control specification forpositioning the predefined section. This may, for example, take placeunder the assumption that the degree of deviation and/or the correctionspecification is dependent on a length of the part of the medical objectarranged in the examination object. This enables the apparatus to beembodied to determine the correction specification for the controlspecification for positioning the predefined section (e.g., in thetarget positioning) by extrapolation and/or interpolation of thecorrection specifications determined so far. This may enableparticularly precise and at the same time efficient positioning of thepredefined section (e.g., taking into account the path along which thepredefined section is moved toward the target positioning).

In a further embodiment of the proposed apparatus, the apparatus may beembodied to determine the positioning information by applying a trainedfunction to the control specification. Herein, at least one parameter ofthe trained function may be based on a comparison of trainingpositioning information with comparison positioning information.

The trained function may be trained by a machine learning method. Forexample, the trained function may be a neural network (e.g., aconvolutional neural network (CNN) or a network including aconvolutional layer). Further, the trained function may be embodied toprocess the control specification as input data and to provide thepositioning information as output data.

The trained function maps input data to output data. The output datamay, for example, also depend on one or more parameters of the trainedfunction. The one or more parameters of the trained function may bedetermined and/or adjusted by training. The determination and/or theadjustment of the one or more parameters of the trained function may,for example, be based on a pair consisting of training input data andassociated training output data, where the trained function is appliedto the training input data to generate training mapping data. Forexample, the determination and/or the adjustment may be based on acomparison of the training mapping data and the training output data. Ingeneral, a trainable function (e.g., a function with one or moreparameters that have not yet been adjusted) is also referred to as atrained function.

Other terms for trained function are trained mapping rule, mapping rulewith trained parameters, function with trained parameters, algorithmbased on artificial intelligence, and machine learning algorithm. Anexample of a trained function is an artificial neural network, where theedge weights of the artificial neural network correspond to theparameters of the trained function. Instead of the term “neuralnetwork”, it is also possible to use the term “neural net”. For example,a trained function may also be a deep neural network or deep artificialneural network. A further example of a trained function is a “supportvector machine”; further, other machine learning algorithms may also beused as the trained function.

The trained function may, for example, be trained by back propagation.First, training mapping data may be determined by applying the trainedfunction to training input data. Thereafter, a deviation between thetraining mapping data and the training output data may be ascertained byapplying an error function to the training mapping data and the trainingoutput data. Further, at least one parameter (e.g., a weighting) of thetrained function (e.g., the neural network) may be iteratively adjustedbased on a gradient of the error function with respect to the at leastone parameter of the trained function. This enables minimization of thedeviation between the training mapping data and the training output dataduring the training of the trained function.

In one embodiment, the trained function (e.g., the neural network)includes an input layer and an output layer. Herein, the input layer maybe embodied to receive input data. Further, the output layer may beembodied to provide mapping data. Herein, the input layer and/or theoutput layer may in each case include a plurality of channels (e.g.,neurons).

The input data of the trained function may be formed by the controlspecification. Further, the output data of the trained function may beformed by the positioning information.

In one embodiment, the at least one parameter of the trained functionmay be based on a comparison between training positioning informationand comparison positioning information. Herein, the training positioninginformation and/or the comparison positioning information may have beendetermined as part of a proposed computer-implemented method forproviding a trained function, which will be explained in the furthercourse of the description. For example, the trained function may beprovided by an embodiment of the proposed computer-implemented methodfor providing a trained function.

Further, the input data of the trained function may additionally bebased on the material parameter and/or the operating parameter of themedical object and/or the physiological parameter of the examinationobject. Further, the input data of the trained function may be based onthe data set (e.g., the centerline model) of the examination objectand/or the medical image data.

The application of the trained function to the control specificationenables the positioning information to be determined efficiently (e.g.,without a capturing unit for capturing the positioning of the predefinedsection).

In a second aspect, the present embodiments relate to a system includingan apparatus according to the present embodiments and a capturing unit.Herein, the capturing unit is embodied to capture the positioning and/orchange in positioning of the predefined section in the examinationobject. Further, the capturing unit is embodied to determine thepositioning information based on the captured positioning and/or changein positioning and to provide the positioning information to theapparatus.

The capturing unit may include a sensor (e.g., an electromagnetic and/oroptical and/or acoustic, such as ultrasound-based, and/or gyroscopicsensor) embodied to detect the predefined section. For this purpose, themedical object (e.g., the predefined section) may, for example, includea marker structure that may be captured (e.g., identified and/orlocalized by the capturing unit). The capturing unit may, for example,be arranged in and/or on the medical object (e.g., the predefinedsection). For example, the capturing unit may be at least partiallyarranged integrated in the medical object (e.g., the predefinedsection). Alternatively or additionally, the capturing unit may bearranged spatially spaced apart from the medical object. The capturingunit may include a capturing area that at least partially includes avolume of the examination object (e.g., the hollow organ), in which themedical object (e.g., the predefined section) is at least partiallyarranged. Herein, the capturing unit may be embodied to capture thepositioning (e.g., instantaneous; a spatial position and/or alignment)of the predefined section. Further, the capturing unit may be embodiedto capture a change in positioning of the predefined section. Forexample, the capturing unit may be embodied to capture a deviation ofthe predefined section from an initial positioning. For example, thecapturing unit may be embodied to determine the positioning and/orchange in positioning of the predefined section with respect to areference positioning (e.g., the initial positioning) and/or absolutely(e.g., with respect to the patient coordinate system). For this purpose,a coordinate system of the capturing unit may be registered with thepatient coordinate system and/or with respect to the moving apparatus.

The capturing unit may further be embodied to provide the positioninginformation to the apparatus based on the captured positioning and/orchange in positioning of the predefined section. The provision of thepositioning information may, for example, include storage on acomputer-readable storage medium and/or displaying on a depicting unitand/or transmission to the providing unit.

The proposed embodiment enables the positioning information to berecorded precisely (e.g., independently of the control specification).This enables the actual positioning and/or change in positioning of thepredefined section to be used to determine the degree of deviation andthe correction specification.

In a further embodiment of the proposed system, the capturing unit mayinclude a medical imaging device embodied to record medical image dataof the examination object. Herein, the predefined section in the medicalimage data may be mapped in a time-resolved manner (e.g.,intraoperatively). Further, the capturing unit may be embodied tocapture the positioning and/or change in positioning of the predefinedsection based on the medical image data.

The medical imaging device may, for example, include a magneticresonance imaging system (MRI) and/or a computed tomography system (CT)and/or a medical X-ray device (e.g., a medical C-arm X-ray device),and/or an ultrasound device, and/or a positron emission tomographysystem (PET). The medical imaging device may be embodied to record themedical image data of the examination object. Herein, the medical imagedata may include a 2D and/or 3D map (e.g., a time-resolved map) of theexamination object (e.g., the hollow organ and/or the predefinedsection). For example, the medical image data may map a movement of thepredefined section in the examination object (e.g., the hollow organ) ina time-resolved manner. In one embodiment, the capturing unit (e.g., themedical imaging device) may be embodied to identify and/or localize thepredefined section in the medical image data. Further, the capturingunit (e.g., the medical imaging device) may be embodied to determine thepositioning and/or change in positioning of the predefined section basedon the medical image data in a time-resolved manner. For this purpose,the capturing unit (e.g., the medical imaging device) may further beembodied to segment the predefined section in the medical image data.Further, the capturing unit (e.g., the medical imaging device) may beembodied to determine the positioning and/or change in positioning ofthe predefined section with respect to a reference map from the medicalimage data and/or absolutely (e.g., with respect to the patientcoordinate system). For this purpose, a coordinate system of the medicalimaging device (e.g., the medical image data) may be registered with thepatient coordinate system and/or with respect to the moving apparatus.The capturing unit (e.g., the medical imaging device) may further beembodied to determine the positioning information based on thepositioning and/or change in positioning of the predefined sectioncaptured based on the medical image data and provide the positioninginformation to the apparatus.

The proposed embodiment enables precise (e.g., image-based) capturing ofthe positioning information (e.g., independently) of the controlspecification. This enables the actual positioning and/or change inpositioning of the predefined section to be used to determine the degreeof deviation and the correction specification.

In a third aspect, the present embodiments relate to a method forproviding a correction specification. Herein, in a first act a), acontrol specification is received by an apparatus (e.g., an apparatusaccording to the present embodiments) for positioning a medical object.Further, the apparatus includes a moving apparatus for roboticallymoving the medical object. Further, the medical object includes apredefined section, where the predefined section is at least partiallyarranged in an examination object. Further, prior to the start of themethod, the predefined section has been positioned by the movingapparatus based on the control specification. In a second act b),positioning information on the predefined section of the medical objectis received. In a third act c), a degree of deviation is determined,where the degree of deviation describes a deviation between the controlspecification and the positioning information. Further, in a fourth actd), the correction specification for minimizing the deviation isdetermined based on the degree of deviation. In a fifth act e), thecorrection specification is provided.

The advantages of the proposed method for providing a correctionspecification substantially correspond to the advantages of the proposedapparatus for positioning a medical object and/or the proposed system.Features, advantages or alternative embodiments mentioned herein maylikewise be transferred to the other subject matter and vice versa.

In one embodiment, the proposed method (e.g., acts a) to e)) may beexecuted after the predefined section of the medical object has beenpositioned (e.g., in the initial positioning).

The reception of the control specification and/or the positioninginformation may, for example, include capturing and/or reading acomputer-readable data memory and/or reception from a data memory unit(e.g., a database). Further, the control specification may be providedby a proposed apparatus and/or a proposed system and/or an input unitfor capturing input from an operator. Further, the positioninginformation may be provided by a proposed apparatus (e.g., a capturingunit) and/or a proposed system.

The control specification and/or the positioning information may, forexample, include all the properties and features as described inrelation to the apparatus for positioning a medical object and viceversa.

The provision of the correction specification in act e) may, forexample, include storage on a computer-readable storage medium and/ordisplaying on a depicting unit and/or transfer to a providing unit. Thecorrection specification provided may support an operator in thecorrection of possible incorrect positioning of the predefined section.

In a further embodiment of the proposed method, the controlspecification may include a specification for spatial positioning (e.g.,a length dimension along the longitudinal extension direction of themedical object and/or an angle of the medical object) and/or a relativemovement of the medical object (e.g., the predefined section) withrespect to the moving apparatus. Further, the positioning informationmay include information on the spatial positioning of the predefinedsection (e.g., the length dimension along the longitudinal extensiondirection of the medical object and/or the angle of the medical object)with respect to the moving apparatus.

In a further embodiment of the proposed method, the controlspecification may include information on a direction of movement, where,prior to the start of the method, the predefined section has beenpositioned along the direction of movement by the moving apparatus.Further, the degree of deviation in act c) may be determined independence on the direction of movement.

In one embodiment, the control specification received in act a) mayinclude information on the direction of movement along which thepredefined section was positioned by the moving apparatus.

The meandering and/or spiraling of the medical object within theexamination object is frequently dependent on the direction of movement(e.g., translational and/or rotational) for positioning the predefinedsection. If the predefined section has been positioned by the movingapparatus along a translational direction of movement facing away fromthe moving apparatus, the meandering and/or spiraling may be intensified(e.g., maximized). If the predefined section has been positioned by themoving apparatus along a translational direction of movement facing themoving apparatus, the meandering and/or spiraling may be reduced (e.g.,minimized). Hence, the deviation between the control specification andthe positioning information may have a different sign in each case independence on the direction of movement (e.g., with respect to themoving apparatus) for the positioning of the predefined section.Further, a manifestation and/or winding direction of the spiraling maybe dependent upon a rotational direction of movement for positioning thepredefined section.

In one embodiment, the degree of deviation may be determined independence on the at least one direction of movement (e.g., along anumber of different directions of movement), along which the predefinedsection was positioned by the direction of movement. Further, in eachcase, a correction specification for minimizing the associated deviationof the at least one direction of movement may be determined based on therespective degree of deviation. This enables the intensification orreduction in the meandering and/or spiraling of the medical object independence on the direction of movement to be taken into account for thedetermination of the degree of deviation and the correctionspecification.

In a further embodiment of the method for providing a correctionspecification, the method may also include act a.2), where a data setincluding a map and/or a model of the examination object may bereceived. Herein, the degree of deviation may be determined in act c)based on the data set and the positioning information.

The reception of the data set (e.g., the map and/or the model) may, forexample, include capturing and/or reading a computer-readable datamemory and/or reception from a data memory unit (e.g., a database).Further, the data set may be provided by a providing unit of the medicalimaging device for recording and/or providing the data set. The data setmay, for example, include all the properties and features as describedin relation to the apparatus for positioning a medical object and viceversa.

When the predefined section has been positioned by the moving apparatusprior to the start of the proposed method, the initial positioningand/or a spatial course of the medical object, which is at leastpartially arranged in the examination object, may be mapped in the dataset based on the control specification. Herein, the initial positioningof the predefined section and/or the spatial course of the medicalobject may be determined (e.g., simulated) based on the controlspecification in the data set. In one embodiment, the meandering and/orspiraling of the medical object may be simulated and/or mapped in thedata set. For this purpose, in act a.2), further a material parameterand/or an operating parameter of the medical object and/or aphysiological parameter of the examination object may be received. Thereception of the material parameter and/or operating parameter of themedical object and/or the physiological parameter of the examinationobject may, for example, include capturing and/or reading acomputer-readable data memory and/or reception from a data memory unit(e.g., a database). Further, the operating parameter may be provided bythe moving apparatus and/or the medical object. Further, thephysiological parameter of the examination object may be provided by asensor unit for capturing the physiological parameter. Further, thematerial parameter and/or the operating parameter of the medical objectand/or the physiological parameter of the examination object may includeall the properties and features as described in relation to theapparatus for positioning a medical object and vice versa.

In one embodiment, the initial positioning of the predefined sectionand/or the spatial course of the medical object may also be simulated inthe data set based on the material parameter and/or the operatingparameter of the medical object and/or the physiological parameter ofthe examination object. This enables the meandering and/or spiraling ofthe medical object in the examination object (e.g., in the hollow organ)to be simulated and/or mapped particularly precisely in the data set.Further, the degree of deviation (e.g., in dependence on the directionof movement along which the predefined section was positioned prior tothe start of the method) may additionally be determined particularlyprecisely based on the data set. In one embodiment, herein, theinformation contained in the data set on the spatial course and/or thespatial extent of the hollow organ may be taken into account for thedetermination of the degree of deviation (e.g., a difference in lengthand/or difference in angle) in dependence on the direction of movement.

In a further embodiment of the method for providing a correctionspecification, the data set may include a centerline model of a vascularsection of the examination object. Herein, the predefined section may bearranged in the vascular section. Further, the degree of deviation maybe determined in act c) with respect to the centerline model.

The centerline model may, for example, include all the properties andfeatures as described in relation to the apparatus for positioning amedical object and vice versa. Further, the initial positioning of thepredefined section and/or the spatial course of the medical object maybe determined (e.g., simulated) based on the control specification inthe centerline model. Further, a spatial course of the at least onecenterline of the centerline model from an entry point of the medicalobject into the examination object to the spatial target positioning ofthe predefined section may describe a mean distance of the medicalobject (e.g., if the medical object were to be arranged along thecenterline). If the predefined section was positioned along a directionof movement facing away from the moving apparatus, the meandering and/orspiraling of the medical object in the hollow organ may result in alengthening of the distance from the entry point to the target positioncompared to the mean distance. Similarly, there may be a shortening ofthe distance from the entry point to the target positioning compared tothe mean distance if the predefined section was positioned along adirection of movement facing the moving apparatus. In one embodiment,the deviation (e.g., the degree of deviation) may be determined in actc) with respect to the centerline model (e.g., with respect to the meandistance). For example, the shortening and/or lengthening of thedistance from the entry point to the target position compared to themean distance may be determined by determining (e.g.,section-by-section) the spatial deviation between the spatial course ofthe medical object and the centerline model (e.g., substantiallyperpendicular to the at least one centerline). Herein, the spatialdeviation between the spatial course of the medical object and thecenterline model (e.g., the at least one centerline) may be limited bythe spatial extent of the hollow organ (e.g., a diameter and/or across-sectional area). For this purpose, the data set may includeinformation regarding the diameter and/or the cross-sectional area ofthe hollow organ along the at least one centerline.

Further, the medical object may include a spatial course in the holloworgan, where the meandering and/or spiraling may cause an at leastsection-by-section shortening and an at least section-by-sectionlengthening of the distance from the entry point to the targetpositioning compared to the mean distance. Herein, the spatial course ofthe medical object may deviate from the centerline, where the at leastsection-by-section shortening and lengthening of the distance from theentry point to the target positioning compared to the mean distance maylead to an at least partial compensation of the difference in length.For this purpose, i the degree of deviation with respect to thecenterline model may be determined.

Moreover, the correction specification for minimizing the deviation mayalso be determined based on the course of the at least one centerline.Here, a curvature and/or spatial extent of the hollow organ may be takeninto account for the determination of the correction specification.

This enables particularly precise correction of incorrect positioning ofthe predefined section (e.g., taking into account the spatial course ofthe medical object in the hollow organ).

In a further embodiment of the proposed method for providing acorrection specification, the method may also include act a.3), where afurther control specification is received by the apparatus. Herein,prior to the start of the method, the medical object may have been movedby the moving apparatus for the initial positioning of the predefinedsection along a first direction of movement based on the controlspecification. Further, prior to the start of the method, the medicalobject may have been moved by the moving apparatus based on the furthercontrol specification against the first direction of movement such thatthe predefined section deviates from an initial positioning. In oneembodiment, thereafter, the degree of deviation may be determined in actc) based on a comparison of the control specification with the furthercontrol specification.

The reception of the further control specification may, for example,include capturing and/or reading a computer-readable data memory and/orreception from a data memory unit (e.g., a database). Further, thefurther control specification may be provided by an input unit forcapturing input from an operator. The further control specification may,for example, include all the features and properties as described inrelation to the control specification and/or in relation to theapparatus for positioning a medical object and vice versa.

The first direction of movement may substantially face toward or awayfrom the moving apparatus. In one embodiment, the deviation of thepredefined section from an initial positioning (e.g., a change inpositioning) may have been captured based on the positioning information(e.g., based on a change in the positioning information).

The meandering and/or spiraling of the medical object at least partiallyarranged in the examination object may be reduced (e.g., minimized) orintensified (e.g., maximized in dependence on the first direction ofmovement). Consequently, after the predefined section has beenpositioned in an initial positioning by the moving apparatus, thespatial course of the medical object may include a lengthening orshortening compared to the mean distance. Due to the fact that, prior tothe start of the method, the medical object has been moved by the movingapparatus based on the further control specification against the firstdirection of movement, herein, the above-described lengthening wasshortened or the above-described shortening was lengthened. For example,herein the state of the spatial course of the medical object that hasbeen lengthened or shortened compared to the mean distance was reversedinto a spatial course that is shortened or lengthened compared to themean distance.

In one embodiment, the degree of deviation may additionally bedetermined based on the comparison of the control specification with thefurther control specification. The comparison of the controlspecification with the further control specification may, for example,include the formation of a difference of the translation and/or rotationof the medical object prespecified by the respective controlspecification with respect to the moving apparatus. Herein, the degreeof deviation (e.g., including a difference in length and/or differencein angle of the medical object) may be determined with respect to theinitial positioning (e.g., between the maximum shortening and maximumlengthening of the arrangement of the medical object in the holloworgan). Herein, the degree of deviation, for example, describes thedifference in length and/or difference in angle that is to becompensated during a movement of the medical object along the directionof movement opposite to the first direction of movement before thepredefined section would deviate from an initial positioning. Herein,the correction specification may be determined based on the degree ofdeviation (e.g., based on the further control specification). Forexample, the degree of deviation describes a slippage of the spatialarrangement of the medical object in the hollow organ, which may bedetermined and provided as a correction specification (e.g., independence on the direction of movement).

The above-described embodiment of the proposed method enables aparticularly precise determination of the degree of deviation and thecorrection specification that was ascertained (e.g., verified) by themovement of the medical object against the first direction of movementthat took place prior to the start of the method.

In a further embodiment of the proposed method for providing acorrection specification, in act a), a plurality of controlspecifications for different initial positionings of the predefinedsection in the examination object may be received. Further, in act a.3),a plurality of further control specifications for the initialpositionings of the predefined section may be received. Herein, thedegree of deviation and the correction specification for the differentinitial positionings in the examination object may be determined.Further, the correction specification may be determined for at least onefurther possible positioning of the predefined section in theexamination object by interpolation and/or extrapolation of thecorrection specifications determined so far.

The different initial positionings of the predefined section may form apath in the examination object (e.g., the hollow organ). For example,prior to the start of the method, the predefined section of the medicalobject may have been moved by the moving apparatus along the path towardthe target positioning. In one embodiment, the degree of deviation andthe correction specification for the different initial positionings(e.g., along the path) may be determined. For example, the degree ofdeviation and the correction specification for the different initialpositionings may, in each case, be determined according to one of theabove-described embodiments (e.g., by a comparison of the in each casemutually corresponding control specifications and further controlspecifications). Further, the correction specification may be determinedfor at least one further possible positioning of the predefined section(e.g., for a possible intermediate positioning along the path and/or forthe target positioning) by interpolation and/or extrapolation of thecorrection specifications determined so far. The at least one furtherpossible positioning may, for example, be specified by an operator inputusing the input unit. For example, the degree of deviation and/or thecorrection specification may be parameterized in dependence on thecontrol specification based on the degrees of deviation and correctionspecifications determined for the different initial positionings. Thisenables the correction specification for the control specification forpositioning the predefined section (e.g., in the target positioning) tobe determined and provided by extrapolation and/or interpolation of thecorrection specifications determined so far.

The above-described embodiment of the proposed method enables aparticularly precise determination of the degree of deviation and thecorrection specification (e.g., taking into account the path along whichthe predefined section was moved toward the target positioning prior tothe start of the method) by the moving apparatus.

According to a further embodiment of the proposed method, in act a), aplurality of control specifications for the different initialpositionings of the predefined section in the examination object may bereceived. Further, in act b), a plurality of items of positioninginformation on the initial positionings of the predefined section may bereceived. Herein, the degree of deviation and the correctionspecification for the different initial positionings in the examinationobject may in each case be determined according to one of theabove-described embodiments. Further, the correction specification forthe at least one further possible positioning of the predefined sectionin the examination object may be determined by interpolation and/orextrapolation of the correction specifications determined so far.

In a further embodiment of the proposed method for providing acorrection specification, the positioning information may be determinedin act b) by applying a trained function to the control specification.Herein, at least one parameter of the trained function may be based on acomparison of training positioning information with comparisonpositioning information.

The trained function and/or the training positioning information and/orthe comparison positioning information may, for example, include all thefeatures and properties as described in relation to the apparatus forpositioning a medical object and vice versa. For example, the trainedfunction may be provided by an embodiment of the proposed method forproviding a trained function.

Hence, the control specification may form the input data of the trainedfunction. Further, the positioning information may form the output dataof the trained function.

Further, the input data of the trained function may also be based on thematerial parameter and/or the operating parameter of the medical objectand/or the physiological parameter of the examination object. Further,the input data of the trained function may be applied to the data set(e.g., the centerline model) of the examination object and/or themedical image data.

The application of the trained function to the control specificationenables an efficient determination of the positioning information (e.g.,without a capturing unit for capturing the positioning of the predefinedsection).

In a further embodiment of the proposed method for providing acorrection specification, the method may also include act b.0), wheremedical image data of the examination object is received. Herein, thepredefined section may be mapped in the medical image data in atime-resolved manner. Further, the positioning information may bedetermined in act b) based on the medical image data.

The reception of the medical image data may, for example, includecapturing and/or reading a computer-readable data memory and/orreception from a data memory unit (e.g., a database). Further, themedical image data may be provided by the medical imaging device forrecording the medical image data. The medical image data may, forexample, include all the properties and features as described inrelation to the apparatus for positioning a medical object and viceversa.

In one embodiment, the predefined section of the medical object may beidentified and/or localized in the medical image data. Further, thepositioning and/or change in positioning of the predefined section maybe determined based on the medical image data in a time-resolved manner.For this purpose, the predefined section may be segmented in the medicalimage data. Further, the positioning and/or change in positioning of thepredefined section with respect to a reference map may be determinedfrom the medical image data and/or absolutely (e.g., with respect to thepatient coordinate system). For this purpose, a coordinate system of themedical imaging device (e.g., the medical image data) may be registeredwith the patient coordinate system and/or with respect to the movingapparatus. Further, the positioning information may be determined in actb) based on the positioning and/or change in positioning of thepredefined section mapped in the medical image data in a time-resolvedmanner.

The proposed embodiment enables a precise determination of thepositioning information of the predefined section (e.g., independentlyof the control specification).

In a fourth aspect, the present embodiments relate to a method (e.g.,computer-implemented) for providing a trained function. Herein, in afirst act t1), training control specifications are received by anapparatus for positioning a medical object. Further, in a second actt2), in each case, comparison positioning information for each of thetraining control specifications for a predefined section of the medicalobject is received. In a third act t3), training positioning informationis determined by applying the trained function to the training controlspecifications. In a fourth act t4), at least one parameter of thetrained function is adjusted based on a comparison of the trainingpositioning information with the comparison positioning information.Further, the trained function is provided in a fifth act t5).

The reception of the training control specifications in act t1) and/orthe reception of the comparison positioning information in act t2) may,for example, include capturing and/or reading a computer-readable datamemory and/or reception from a data memory unit (e.g., a database).Further, the training control specification may be provided by an inputunit for capturing input from an operator and/or a proposed apparatusfor positioning a medical object. Further, the comparison positioninginformation may be provided by a capturing unit (e.g., a medical imagingdevice) for capturing a positioning and/or change in positioning of thepredefined section of the medical object.

The training control specifications may, for example, include all theproperties of the control specification as described in relation to theapparatus for positioning a medical object and/or in relation to themethod for providing a correction specification and vice versa. Further,the comparison positioning information may include all the properties ofpositioning information described in relation to the apparatus forpositioning a medical object and/or in relation to the method forproviding a correction specification and vice versa. Further, thetraining control specifications and/or the comparison positioninginformation may be simulated.

In one embodiment, in act t1), a plurality of training controlspecifications (e.g., different training control specifications) for atleast one examination object (e.g., different examination objects) maybe received. Further, in act t2), in each case, comparison positioninginformation on each of the training control specifications may bereceived. Herein, the comparison positioning information may in eachcase include information on the spatial positioning and/or change inpositioning of the predefined section, where, prior to the start of themethod, the predefined section has been positioned (e.g., in a simulatedmanner) by the moving apparatus based on the respective training controlspecification. In one embodiment, the comparison positioning informationmay in each case describe the actual positioning of the predefinedsection.

In act t3), training positioning information may be determined byapplying the trained function to the training control specifications. Inother words, the training control specifications may form the input dataof the trained function, and the training positioning information mayform the output data of the trained function. Further, the input data ofthe trained function may be based on the material parameter and/or theoperating parameter of the medical object and/or the physiologicalparameter of the examination object as described in relation to themethod for providing a correction specification. Further, the input dataof the trained function may be based on a data set (e.g., a centerlinemodel) of the examination object and/or the medical image data asdescribed in relation to the method for providing a correctionspecification.

In act t4), the at least one parameter of the trained function may beadjusted based on the comparison of the training positioning informationwith the comparison positioning information. Herein, the comparison may,for example, include a determination of a difference in length and/ordifference in angle between mutually corresponding items of trainingpositioning information in each case based on the training controlspecification and comparison positioning information. In one embodiment,the at least one parameter may be adjusted such that a deviation betweenthe comparison positioning information and training positioninginformation is minimized.

The provision of the trained function in act t5) may, for example,include storage on a computer-readable storage medium and/or transfer toa providing unit (e.g., to a proposed apparatus for positioning amedical object).

In one embodiment, the proposed method may provide a trained functionthat may be used in one embodiment of the apparatus for positioning themedical object and/or the method for providing a correctionspecification.

The present embodiments may further relate to a providing unit includinga computing unit, a memory unit, and an interface. Herein, the providingunit may be embodied to execute an embodiment of the proposed method forproviding a correction specification in that the components of theproviding unit are embodied to execute the individual method acts. Forexample, the interface may be embodied to execute acts a) (e.g., thefurther subacts a.1) to a.3)), b) (e.g., the further subact b.0)),and/or e). Further, the computing unit and/or the memory unit may beembodied to execute the other acts.

The advantages of the proposed providing unit substantially correspondto the advantages of the proposed method for providing a correctionspecification. Features, advantages, or alternative embodimentsmentioned here may likewise also be transferred to the other subjectmatter and vice versa.

The present embodiments may further relate to a training unit includinga training computing unit, a training memory unit, and a traininginterface. Herein, the training unit may be embodied to execute anembodiment of the proposed method for providing a trained function inthat the components of the training unit are embodied to execute theindividual method acts. For example, the training interface may beembodied to execute acts t1), t2), and/or t5). Further, the trainingcomputing unit and/or the training memory unit may be embodied toexecute acts t3) and t4).

The advantages of the proposed training unit substantially correspond tothe advantages of the proposed method for providing a trained function.Features, advantages, or alternative embodiments may likewise betransferred to the other subject matter and vice versa.

In a fifth aspect, the present embodiments relate to a computer programproduct with a computer program that may be loaded directly into amemory of a providing unit, with program sections for executing all theacts of the computer-implemented method for providing a correctionspecification and/or one of the aspects thereof when the programsections are executed by the providing unit. Alternatively oradditionally, the computer program product may include a computerprogram that may be loaded directly into a training memory of a trainingunit with program sections for executing all the acts of the proposedmethod for providing a trained function and/or one of the aspectsthereof when the program sections are executed by the training unit.

The present embodiments may further relate to a computer-readablestorage medium on which program sections that may be read and executedby a providing unit are stored for executing all the acts of the methodfor providing a correction specification and/or one of the aspectsthereof when the program sections are executed by the providing unit.Alternatively or additionally, the computer-readable storage medium maystore program sections that may be read and executed by a training unitto execute all the acts of the method for providing a trained functionand/or one of the aspects thereof when the program sections are executedby the training unit.

The present embodiments may further relate to a computer program orcomputer-readable storage medium including a trained function providedby a proposed computer-implemented method or one of the aspects thereof.

An extensively software-based implementation has the advantage that itis also possible to retrofit providing units and/or training units usedto date in a simple way by a software update in order to work in themanner according to the present embodiments. In addition to the computerprogram, such a computer program product may optionally includeadditional parts such as, for example, documentation and/or additionalcomponents, and also hardware components, such as, for example, hardwarekeys (e.g., dongles, etc.) for using the software.

BRIEF DESCRIPTION OF THE DRAWINGS

Exemplary embodiments are depicted in the drawings and will be describedin more detail below. In different figures, the same referencecharacters denote the same features.

FIGS. 1 and 2 show schematic depictions of different embodiments of aproposed apparatus for positioning a medical object and a proposedsystem;

FIG. 3 shows a schematic depiction of a moving apparatus;

FIG. 4 shows a schematic depiction of the positioning of the predefinedsection;

FIGS. 5 to 10 show schematic depictions of different embodiments of aproposed method for providing a correction specification;

FIG. 11 shows a schematic depiction of a proposed method for providing atrained function;

FIG. 12 shows a schematic depiction of a providing unit; and

FIG. 13 shows a schematic depiction of a training unit.

DETAILED DESCRIPTION

FIG. 1 shows a schematic depiction of a proposed apparatus forpositioning a medical object and a proposed system. Herein, theapparatus may include a moving apparatus CR for robotically moving themedical object MD. The moving apparatus CR may, for example, be embodiedas a catheter robot (e.g., for the remote manipulation of the medicalobject MD). The medical object MD may be embodied as, for example, anelongated, surgical instrument and/or a diagnostic instrument. Forexample, the medical object MD may be flexible and/or mechanicallydeformable. The medical object MD may, for example, be embodied as acatheter and/or endoscope and/or guide wire. In one embodiment, themedical object MD may be introduced into an examination object 31 (e.g.,into a hollow organ of the examination object 31) arranged on thepatient support apparatus 32 via an introducer sheath. Herein, thepatient support apparatus 32 may be at least partially movable. For thispurpose, the patient support apparatus 32 may include, for example, amoving apparatus BV. The moving apparatus BV is controllable by a signal28 from the providing unit 22.

Further, the medical object MD may include a predefined section VD.Herein, the predefined section VD may, for example, describe a tipand/or a section including a marker structure on the medical object MD.The predefined section VD of the medical object MD may at leastpartially be arranged in the examination object (e.g., the holloworgan). Herein, the hollow organ may, for example, include a vascularsection in which the predefined section VD is at least partiallyarranged.

Further, the moving apparatus CR may be fastened (e.g., such that themoving apparatus CR may move) using a fastening element 71 (e.g., astand and/or robot arm) on the patient support apparatus 32. In oneembodiment, the moving apparatus CR may be embodied to move the medicalobject MD arranged therein in a translational manner at least along alongitudinal extension direction of the medical object MD. Further, themoving apparatus CR may be embodied to rotate the medical object MDabout the longitudinal extension direction. Alternatively oradditionally, the moving apparatus CR may be embodied to control amovement of at least part of the medical object MD (e.g., a distalsection and/or a tip of the medical object MD). Further, the movingapparatus CR may be embodied to deform the predefined section VD of themedical object MD in a defined manner (e.g., via a cable pull within themedical object MD).

The apparatus may further include a providing unit 22. Herein, theapparatus (e.g., the providing unit 22) may be embodied to receive acontrol specification. The reception of the control specification may,for example, include capturing and/or reading a computer-readable datamemory and/or reception from a data memory unit (e.g., a database).Further, the control specification may be provided by an input unit 42for capturing input from an operator. The input unit 42 may, forexample, include a keyboard and/or a pointing device (e.g., a computermouse). Further, the apparatus may include a depicting unit 41 (e.g., amonitor and/or a display). Herein, the input unit 42 may be at leastpartially integrated in the depicting unit 41 (e.g., in the case of acapacitive and/or resistive input display).

The control specification may include at least one command for control(e.g., step-by-step control) of the moving apparatus CR. For example,the control specification may include at least one command (e.g., atemporal sequence of commands) for specifying a translation and/orrotation (e.g., simultaneous translation and rotation) of the medicalobject MD (e.g., the predefined section VD) by the moving apparatus CR.In one embodiment, the providing unit 22 may be embodied to translatethe control specification and to control the moving apparatus CR basedthereon. Moreover, the moving apparatus CR may be embodied to positionthe medical object MD based on the control specification (e.g., to movethe medical object MD in a translational and/or rotational manner).

The apparatus (e.g., the providing unit 22) may further be embodied toreceive positioning information on the predefined section VD. Thepositioning information may include information on a spatial positionand/or alignment and/or pose (e.g., instantaneous) of the predefinedsection VD in the examination object 31.

In one embodiment, the control specification may include a specificationfor spatial positioning (e.g., a length dimension along the longitudinalextension direction of the medical object MD and/or an angle of themedical object MD, and/or a relative movement of the medical object MD,such as the predefined section VD) with respect to the moving apparatusCR. The positioning information may also include information on thespatial positioning of the predefined section VD (e.g., the lengthdimension along the longitudinal extension direction of the medicalobject MD and/or the angle of the medical object MD) with respect to themoving apparatus CR.

Herein, FIG. 1 shows an embodiment of the proposed system, including aproposed apparatus and a capturing unit SEN, where the capturing unit isembodied to capture the positioning and/or change in positioning of thepredefined section VD in the examination object 31. Further, thecapturing unit SEN may be embodied to determine the positioninginformation based on the captured positioning and/or change inpositioning and provide it to the apparatus (e.g., the providing unit22), for example, by a signal 35. The capturing unit SEN may include asensor (e.g., an electromagnetic and/or optical and/or acoustic, such asultrasound-based, and/or gyroscopic sensor) embodied to detect thepredefined section VD. The capturing unit SEN may, for example, bearranged in and/or on the medical object MD (e.g., the predefinedsection VD). For example, the capturing unit SEN may at least partiallybe arranged integrated in the medical object MD (e.g., the predefinedsection VD).

Alternatively or additionally, the apparatus may be embodied todetermine the positioning information by applying a trained function tothe control specification, where at least one parameter of the trainedfunction (TF) is based on a comparison of training positioninginformation (TPI) with comparison positioning information (VPI).

The apparatus (e.g., the providing unit 22) may further be embodied todetermine a degree of deviation, where the degree of deviation describesa deviation between the control specification and the positioninginformation. Further, the apparatus (e.g., the providing unit 22) may beembodied to determine a correction specification for minimizing thedeviation based on the degree of deviation. The moving apparatus CR mayfurther be embodied to reposition the predefined section VD based on thecorrection specification.

Herein, the input of the operator at the input unit 42 may enable acontrol (e.g., supplementary control) of the apparatus (e.g., the movingapparatus CR), and/or the system, and/or the patient support apparatus32. For this purpose, the input element 42 may, for example, send asignal 26 to the providing unit 22.

Further, the depicting unit 41 may be embodied to display informationand/or graphical depictions of information from the apparatus (e.g., themoving apparatus CR), and/or the system (e.g., the controlspecification), and/or the positioning information, and/or the degree ofdeviation, and/or the correction specification. For this purpose, theproviding unit 22 may, for example, send a signal 25 to the depictingunit 41.

FIG. 2 shows a further embodiment of the proposed system, where thecapturing unit SEN may include a medical imaging device (e.g., a medicalC-arm X-ray device 37). The medical C-arm X-ray device 37 may beembodied to record medical image data from the examination object 31.

In the exemplary embodiment, as a medical C-arm X-ray device 37, themedical imaging device may include a detector 34 (e.g., an X-raydetector) and an X-ray source 33. To record the image data, the arm 38of the medical C-arm X-ray device 37 may be mounted such that the arm 38may move about one or more axes. Further, the medical C-arm X-ray device37 may include a moving apparatus 39 that enables the medical C-armX-ray device 37 to move in space. The detector 34 and the X-ray source34 may be fastened such that the detector 34 and the X-ray source 34 maymove in a defined arrangement on a common C-arm 38.

The providing unit 22 may also be embodied to control a positioning ofthe medical C-arm X-ray device 37 relative to the examination object 31such that the predefined section VD of the medical object MD is mappedin the medical image data recorded by the medical C-arm X-ray device 37.The positioning of the medical C-arm X-ray device 37 relative to theexamination object 31 may, for example, include positioning the definedarrangement of X-ray source 33 and detector 34 (e.g., the C-arm 38,about one or more spatial axes). Further, the medical C-arm X-ray device37 may include a moving apparatus 39 (e.g., a wheel system and/or railsystem and/or robot arm) that enables movement of the medical C-armX-ray device 37 in space.

To record the medical image data from the examination object 31, theproviding unit 22 may send a signal 24 to the X-ray source 33. Inresponse, the X-ray source 33 may emit an X-ray beam (e.g., a cone beamand/or fan beam and/or parallel beam). When, after interaction with theexamination area of the examination object 31 to be mapped, the X-raybeam impinges on a surface of the detector 34, the detector 34 may senda signal 21 to the providing unit 22. The providing unit 22 may, forexample, receive the medical image data based on the signal 21.

In one embodiment, the predefined section VD may be mapped in atime-resolved manner in the medical image data. Herein, the capturingunit SEN (e.g., the medical C-arm X-ray device 37) may be embodied tocapture the positioning and/or change in positioning of the predefinedsection VD based on the medical image data. The depicting unit 41 mayfurther be embodied to display a graphical depiction of the medicalimage data.

FIG. 3 shows a schematic depiction of the moving apparatus CR forrobotically moving the medical object MD. In one embodiment, the movingapparatus CR may include a fastening element 71 (e.g., a movable and/ormobile fastening element 71). Further, the moving apparatus CR mayinclude a cassette element 74 embodied to record at least part of themedical object MD. Further, the moving apparatus CR may include a movingelement 72 fastened to the fastening element 71 (e.g., a stand and/orrobot arm). The fastening element 71 may also be embodied to fasten themoving element 72 to the patient support apparatus 32 (e.g., such thatthe fastening element 71 may move). Further, the moving element 72 mayinclude at least one (e.g., three) actuator elements 73 (e.g., anelectric motor), where the providing unit 22 is embodied to control theat least one actuator element 73. In one embodiment, the cassetteelement 74 may be coupled (e.g., mechanically and/or electromagneticallyand/or pneumatically) to the moving element 72 (e.g., the at least oneactuator element 73). Herein, the cassette element 74 may furtherinclude at least one transferring element 75 that may be moved by thecoupling between the cassette element 74 and the moving element 72(e.g., the at least one actuator element 73). For example, the at leastone transferring element 75 may be motion-coupled to the at least oneactuator element 73. Further, the transferring element 75 may beembodied to transfer a movement of the actuator element 73 to themedical object MD such that the medical object MD is moved along alongitudinal extension direction of the medical object MD and/or themedical object MD is rotated about the longitudinal extension direction.The at least one transferring element 75 may, for example, include aroll and/or roller and/or diaphragm and/or shear plate.

In one embodiment, the moving element 72 may include a plurality ofactuator elements 73 (e.g., independently controllable actuatorelements). Further, the cassette element 74 may include a plurality oftransferring elements 75 (e.g., at least one motion-coupled transferringelement 75 for each of the actuator elements 73). This enables amovement (e.g., an independent and/or simultaneous movement) of themedical object MD along different degrees of freedom of movement.

Further, the moving apparatus CR (e.g., the at least one actuatorelement 73) may be controlled by the signal 35 from the providing unit22. This enables the movement of the medical object MD to be controlled(e.g., indirectly) by the providing unit 22. The alignment and/orposition of the moving apparatus CR relative to the examination object31 may also be adjusted by a movement of the fastening element 71. Themoving apparatus CR may be embodied to receive the controlspecification.

Further, the moving apparatus CR may include a sensor unit 77 embodiedto capture a relative movement of the medical object MD relative to themoving apparatus CR. Herein, the sensor unit 77 may, for example,include an encoder (e.g., a wheel encoder and/or a roller encoder),and/or an optical sensor (e.g., a barcode scanner and/or a laser scannerand/or a camera), and/or an electromagnetic sensor. For example, thesensor unit 77 may be at least partially arranged integrated in themoving element 72 (e.g., the at least one actuator element 73) and/orthe cassette element 74 (e.g., the at least one transferring element75). The sensor unit 77 may, for example, be embodied to capture therelative movement of the medical object MD by capturing the medicalobject MD relative to the moving apparatus CR. Alternatively oradditionally, the sensor unit 77 may be embodied to capture a movementand/or change in position of components of the moving apparatus CR thatare motion-coupled to the medical object MD (e.g., the at least oneactuator element 73 and/or the at least one transferring element 74).

FIG. 4 shows a schematic depiction of the positioning of the predefinedsection VD in a hollow organ HO (e.g., a vascular section) of theexamination object 31. The hollow organ HO may, for example, include avascular section in which the predefined section VD is arranged. In oneembodiment, the apparatus may be embodied to determine the degree ofdeviation in dependence on a direction of movement FW, BW, along whichthe moving apparatus CR is embodied to position the predefined sectionVD. In one embodiment, the apparatus (e.g., the providing unit 22) maybe embodied to receive a data set including a map and/or a model (e.g.,a centerline model) of the examination object (e.g., the hollow organHO). Herein, the data set may map the examination object 31 (e.g.,preoperatively and/or intraoperatively). The apparatus may further beembodied to determine the degree of deviation additionally based on thedata set (e.g., with respect to the centerline model).

The centerline model may include at least one centerline CL. Thecenterline CL describes the spatial course of the hollow organ HO (e.g.,at least a vascular section of the examination object 31) spatially(e.g., two-dimensionally and/or three-dimensionally). If the data set(e.g., the centerline model) describes (e.g., maps) the spatial courseof the hollow organ HO two-dimensionally, the apparatus may, forexample, be embodied to ascertain and supplement depth information byapplying an algorithm for estimating the depth information to the dataset. Herein, the at least one centerline CL may be a midline of thehollow organ HO, which, in each case, extends along a longitudinalextension direction of the hollow organ HO through the midpoint of thecross-sectional area of the hollow organ HO. For example, the apparatusmay be embodied to determine (e.g., to simulate) the initial positioningIP of the predefined section VD and/or the spatial course of the medicalobject MD based on the control specification in the centerline model.

Herein, a spatial course of the at least one centerline CL from an entrypoint EP of the medical object MD into the examination object 31 to thespatial target positioning TP of the predefined section VD may describea mean distance of the medical object MD (e.g., if the medical object MDwere to be arranged along the at least one centerline CL). Whenpositioning the predefined section VD along a direction (e.g., atranslational direction) of movement FW facing away from the movingapparatus CR, meandering and/or spiraling of the medical object MD.FW inthe hollow organ HO may result in a lengthening of the distance from theentry point EP to the target positioning TP compared to the meandistance. Here, the predefined section VD.FW may include the initialpositioning IP. Further, when the predefined section VD is positionedalong a direction (e.g., translational direction) of movement BW facingthe moving apparatus CR, there may be a shortening (e.g., truncation) ofthe distance from the entry point EP to the target positioning TPcompared to the mean distance. In one embodiment, the apparatus may beembodied to determine the deviation (e.g., the degree of deviation) withrespect to the centerline model (e.g., the mean distance). Herein, theapparatus may further be embodied to determine the shortening and/orlengthening of the distance from the entry point EP to the targetpositioning TP compared to the mean distance by determining (e.g.,section-by-section) a spatial deviation between the spatial course ofthe medical object MD.FW, MF.BW and the centerline model (e.g.,substantially perpendicular to the at least one centerline CL). Herein,the spatial deviation between the spatial course of the medical objectMD.FW, MD.BW and the centerline model may be limited by the spatialextent of the hollow organ HO (e.g., a diameter and/or a cross-sectionalarea). The apparatus may, for example, be embodied to ascertain thedegree of deviation based on the control specification and thecenterline model (e.g., in dependence on the direction of movement FW,BW for positioning the predefined section VD). For example, theapparatus may be embodied to ascertain (e.g., to simulate) arelationship between the lengthened MD.FW and the shortened spatialcourse of the medical object MD.BW (e.g., a difference in length and/ordifference in angle) in the examination object 31 based on the controlspecification and the centerline model.

Further, the apparatus may be embodied to determine (e.g., to verify)the centerline model (e.g., the at least one centerline CL) based on acomparison and/or an averaging of the lengthened MD.FW and the shortenedspatial course of the medical object MD.BW in the examination objectadditionally based on the positioning information. Similarly, theapparatus may be embodied to verify the relationship between thelengthened MD.FW and the shortened spatial course of the medical objectMD.BW (e.g., the difference in length and/or difference in angle) in theexamination object 31 additionally based on the positioning information.This enables a quality of the determination of the degree of deviationto be improved.

The moving apparatus CR may further be embodied to move the medicalobject MD for positioning the predefined section VD in an initialpositioning IP of the predefined section VD along a first direction ofmovement FW based on the control specification. Further, the movingapparatus CR may be embodied to move the medical object MD based on afurther control specification against BW the first direction of movementsuch that the predefined section VD.BW starts to leave its initialpositioning IP. Herein, the apparatus may be embodied to additionallydetermine the degree of deviation based on a comparison of the controlspecification with the further control specification.

Further, the apparatus may be embodied to determine the degree ofdeviation and the correction specification for different initialpositionings IP of the predefined section in the examination object 31(e.g., in the hollow organ HO). Moreover, the apparatus may be embodiedto determine the correction specification for at least one furtherpositioning of the predefined section VD (e.g., the target positioningTP) in the examination object by interpolation and/or extrapolation ofthe correction specifications determined so far.

FIG. 5 shows a schematic depiction of an embodiment of the method forproviding a correction specification PROV-CC. Herein, in a first act a),the control specification SC may be received REC-SC by a proposedapparatus for positioning a medical object MD. Herein, prior to thestart of the method, the predefined section VD may have been positionedby the moving apparatus CR based on the control specification SC. In asecond act b), the positioning information PI on the predefined sectionVD of the medical object MD may be received REC-PI. In a third act c),the degree of deviation DIFF may be determined DET-DIFF, where thedegree of deviation DIFF describes a deviation between the controlspecification SC and the positioning information PI. In a fourth act d),the correction specification CC for minimizing the deviation isdetermined DET-CC based on the degree of deviation DIFF. In a fifth acte), the correction specification CC may be provided PROV-CC.

The control specification SC may, for example, include information on adirection of movement FW, BW, where, prior to the start of the method,the predefined section VD has been positioned along the direction ofmovement FW, BW by the moving apparatus CR. Further, the degree ofdeviation CC may be determined DET-CC in act c) in dependence on thedirection of movement FW, BW.

FIG. 6 shows a schematic depiction of a further embodiment of theproposed method for providing a correction specification PROV-CC.Herein, in act a.2), a data set DS including a map and/or a model of theexamination object 31 may be received REC-DS. Further, the degree ofdeviation may, for example, additionally be determined in act c) basedon the data set DS and the positioning information PI.

In one embodiment, the data set DS may include a centerline model of avascular section of the examination object 31, where the predefinedsection VD is arranged in the vascular section. Further, the degree ofdeviation DIFF may be determined DET-DIFF in act c) with respect to thecenterline model. Herein, the data set DS may map the examination object31 (e.g., preoperatively and/or intraoperatively).

FIG. 7 shows a schematic depiction of a further embodiment of theproposed method for providing a correction specification PROV-CC.Herein, in a further act a.3), a further control specification SC2 maybe received by the proposed apparatus. In one embodiment, prior to thestart of the method, the medical object MD may have been moved by themoving apparatus CR for positioning the predefined section VD in theinitial positioning IP along a first direction of movement FW based onthe control specification SC. Further, prior to the start of the method,the medical object MD may have been moved by the moving apparatus CRbased on the further control specification SC2 against BW the firstdirection of movement such that the predefined section VD deviates froman initial positioning IP. Herein, the degree of deviation DIFF may bedetermined DET-CC in act c) (e.g., based on a comparison COMP-SC-SC2 ofthe control specification SC with the further control specificationSC2).

FIG. 8 shows a schematic depiction of a further embodiment of theproposed method for providing a correction specification PROV-CC.Herein, in act a), a plurality of control specifications SC.iter fordifferent initial positionings IP.iter of the predefined section VD inthe examination object 31 may be received REC-SC. Further, in act a.3),a plurality of further control specifications SC2.iter for the initialpositionings IP.iter of the predefined section VD may be receivedREC-SC2. In one embodiment, the degree of deviation DIFF.iter and thecorrection specification CC.iter for the different initial positioningsIP.iter in the examination object may be determined DET-DIFF, DET-CC.Thereafter, the correction specification CC-TP for at least one furtherpossible positioning (e.g., the received REC-TP target positioning TP)of the predefined section VD in the examination object may be determinedCALC-CC by interpolation and/or extrapolation of the correctionspecifications CC.ter determined so far.

FIG. 9 shows a schematic depiction of a further embodiment of theproposed method for providing a correction specification PROV-CC.Herein, the positioning information PI may be determined in act b) byapplying a trained function TF to the control specification SC. In oneembodiment, at least one parameter of the trained function TF may bebased on a comparison of training positioning information withcomparison positioning information.

The movement of the medical object MD may be composed of a translation Tand a rotation R. Herein, a distinction may be made between an attackposition of the manipulation for moving the medical object MD and aneffect position of the resulting positioning of the predefined sectionVD. If R(CR) describes the rotation and T(CR) describes the translationof the medical object MD at the attack position on the moving apparatusCR, R(VD), and T(VD) may describe the resulting rotation or translationof the predefined section. Hence, the effect of a movement of themedical object MD by the moving apparatus CR on the positioning of thepredefined section VD may be described as:

[R(VD),T(VD)]=TF[R(CR),T(CR)]  (1),

where the rotation R(CR) and the translation T(CR) of the medical objectMD on the moving apparatus CR are prespecified by the controlspecification. Further, the effect of the rotation R(CR) and translationT(CR) of the medical object MD by the moving apparatus CR on thepositioning of the predefined section VD may be described by thepositioning information. The information contained in the positioninginformation on the spatial position and alignment (e.g., instantaneous)of the predefined section VD may be described by the translation T (VD)and rotation R (VD) of the predefined section VD. The determinationand/or adjustment of the at least one parameter of the trained functionTF may, for example, be based on a pair consisting of training inputdata and associated training output data. Hence, a pair of training datamay include training control specifications (e.g., different rotations R(CR) and translations T(CR)) of the medical object MD by he movingapparatus CR, and comparison positioning information on the predefinedsection (e.g., the rotations R(VD) and translations T(VD) of thepredefined section VD corresponding to the rotations R(CR) andtranslations T(CR) of the medical object). Further, the input data ofthe trained function TF may also be based on the material parameterand/or the operating parameter of the medical object and/or thephysiological parameter of the examination object 31. Further, the inputdata of the trained function TF may be based on the data set DS (e.g.,the centerline model) of the examination object 31 and/or the medicalimage data ID.

It is also possible to determine the inverse TF⁻¹ of the trainedfunction TF:

[R(CR), T(CR)]=TF ⁻¹[R(VD), T(VD)]  (2).

FIG. 10 shows a schematic depiction of a further embodiment of themethod for providing a correction specification PROV-CC. Herein, in anact b.0), medical image data ID of the examination object may bereceived REC-ID by a medical imaging device (e.g., the medical C-armX-ray device 37). Further, the predefined section VD may be mapped inthe medical image data ID in a time-resolved manner. Herein, thepositioning information may be determined DET-PI in act b) based on themedical image data ID.

FIG. 11 shows a schematic depiction of an embodiment of a method forproviding a trained function PROV-TF. In a first act t1), trainingcontrol specifications TSC may be received REC-TSC by a proposedapparatus for positioning a medical object MD. In a second act t2), ineach case, comparison positioning information VPI for each of thetraining control specifications TSC for the predefined section VD of themedical object MD may be received REC-VPI. In a third act t3), trainingpositioning information TPI may be determined by applying the trainedfunction TF to the training control specifications TSC. Further, in actt4), at least one parameter of the trained function TF may be adjustedADJ-TF based on a comparison of the training positioning information TPIwith the comparison positioning information VPI. Thereafter, the trainedfunction TF may be provided PROV-TF in act t5).

FIG. 12 shows a schematic depiction of a proposed providing unit 22.Herein, the providing unit 22 may include an interface IF, a computingunit CU, and a memory unit MU. The providing unit 22 may be embodied toexecute a method for providing a correction specification PROV-CC andthe aspects thereof in that the interface IF, the computing unit CU, andthe memory unit CU are embodied to execute the corresponding methodacts. For example, the interface IF may be embodied to execute acts a)(e.g., the further subacts a.1) to a.3), b), such as the further subactb.0) and/or e). Further, the computing unit CU and/or the memory unit MUmay be embodied to execute the other acts.

FIG. 13 shows a schematic depiction of a proposed training unit TRS. Thetraining unit TRS may include a training interface TIF, a trainingmemory unit TMU, and a training computing unit TCU. The training unitTRS may be embodied to execute a method for providing a trained functionPROV-TF and the aspects thereof in that the training interface TIF, thetraining memory unit TMU, and the training computing unit TCU areembodied to execute the corresponding method acts. For example, thetraining interface TIF may be embodied to execute acts t1), t2), and/ort5). Further, the training computing unit TCU and/or the training memoryunit TMU may be embodied to execute acts t3) and t4).

The providing unit 22 and/or the training unit TRS may, for example, bea computer, a microcontroller, or an integrated circuit. Alternatively,the providing unit 22 and/or the training unit TRS may be a real orvirtual group (a technical term for a real group is “cluster”; atechnical term for a virtual group is “cloud”). The providing unit 22and/or the training unit TRS may also be embodied as a virtual systemexecuted on a real computer or a real or virtual group of computers(e.g., virtualization).

An interface IF and/or a training interface TIF may be a hardware orsoftware interface (e.g., PCI bus, USB, or Firewire). A computing unitCU and/or a training computing unit TCU may include hardware elements orsoftware elements (e.g., a microprocessor or a field programmable gatearray (FPGA)). A memory unit MU and/or a training memory unit TMU may beimplemented as a non-permanent working memory (e.g., random accessmemory (RAM)) or as a permanent mass memory (e.g., hard disk, USB stick,SD card, solid state disk).

The interface IF and/or the training interface TIF may, for example,include a plurality of sub-interfaces that execute the different acts ofthe respective method. In other words, the interface IF and/or thetraining interface TIF may also be understood as a large number ofinterfaces IF or a large number of training interfaces TIF. Thecomputing unit CU and/or the training computing unit TCU may, forexample, include a plurality of sub-computing units that execute thedifferent acts of the respective method. In other words, the computingunit CU and/or the training computing unit TCU may also be understood asa large number of computing units CU or a large number of trainingcomputing units TCU.

The schematic depictions contained in the described figures do notrepresent any kind of scale or size ratio.

Reference is made once again to the fact that the methods describedabove in detail and the apparatuses depicted are merely exemplaryembodiments that may be modified in a wide variety of ways by the personskilled in the art without leaving the scope of the invention. Further,the use of the indefinite article “a” or “an” does not preclude thepossibility that the features in question may also be present on amultiple basis. Likewise, the terms “unit” and “element” do not precludethe possibility that the components in question may consist of aplurality of interacting sub-components that may optionally also bespatially distributed.

The elements and features recited in the appended claims may be combinedin different ways to produce new claims that likewise fall within thescope of the present invention. Thus, whereas the dependent claimsappended below depend from only a single independent or dependent claim,it is to be understood that these dependent claims may, alternatively,be made to depend in the alternative from any preceding or followingclaim, whether independent or dependent. Such new combinations are to beunderstood as forming a part of the present specification.

While the present invention has been described above by reference tovarious embodiments, it should be understood that many changes andmodifications can be made to the described embodiments. It is thereforeintended that the foregoing description be regarded as illustrativerather than limiting, and that it be understood that all equivalentsand/or combinations of embodiments are intended to be included in thisdescription.

1. An apparatus for positioning a medical object, the apparatuscomprising: a moving apparatus operable to robotically move the medicalobject, wherein the medical object comprises a predefined section,wherein the predefined section is at least partially arranged in anexamination object, wherein the apparatus is configured to receive acontrol specification, wherein the moving apparatus is configured toposition the predefined section based on the control specification,wherein the apparatus is further configured to: receive positioninginformation on the predefined section; determine a degree of deviation,wherein the degree of deviation describes a deviation between thecontrol specification and the positioning information; and determine acorrection specification for minimizing the deviation based on thedegree of deviation, and wherein the moving apparatus is furtherconfigured to reposition the predefined section based on the correctionspecification.
 2. The apparatus of claim 1, wherein the controlspecification includes a specification for spatial positioning withrespect to the moving apparatus, an angle of the medical object withrespect to the moving apparatus, a relative movement of the medicalobject with respect to the moving apparatus, or any combination thereof,and wherein the positioning information includes information on aspatial positioning of the predefined section with respect to the movingapparatus, the angle of the medical object with respect to the movingapparatus, or the information on the spatial positioning of thepredefined section with respect to the moving apparatus and the angle ofthe medical object with respect to the moving apparatus.
 3. Theapparatus of claim 1, wherein the apparatus is further configured todetermine the degree of deviation in dependence on a direction ofmovement along which the moving apparatus is configured to position thepredefined section.
 4. The apparatus of claim 1, wherein the apparatusis further configured to receive a data set comprising a map, a model,or the map and the model of the examination object, and wherein theapparatus is further configured to also determine the degree ofdeviation based on the data set.
 5. The apparatus of claim 4, whereinthe data set comprises a centerline model of a vascular section of theexamination object, wherein the predefined section is arranged in thevascular section, and wherein the apparatus is further configured todetermine the deviation with respect to the centerline model.
 6. Theapparatus of claim 1, wherein the moving apparatus is further configuredto: move the medical object for positioning the predefined section in aninitial positioning along a first direction of movement based on thecontrol specification; and move the medical object based on a furthercontrol specification against the first direction of movement such thatthe predefined section starts to leave an initial positioning, whereinthe apparatus is further configured to determine the degree of deviationbased on a comparison of the control specification with the furthercontrol specification.
 7. The apparatus of claim 1, wherein theapparatus is further configured to: determine the degree of deviationand the correction specification for different initial positionings ofthe predefined section in the examination object; and determine thecorrection specification for at least one further positioning of thepredefined section in the examination object, the determination of thecorrection specification comprising interpolation, extrapolation, orinterpolation and extrapolation of the correction specificationsdetermined so far.
 8. The apparatus of claim 1, wherein the apparatus isfurther configured to determine the positioning information, thedetermination of the positioning information comprising application of atrained function to the control specification, and wherein at least oneparameter of the trained function is based on a comparison of trainingpositioning information with comparison positioning information.
 9. Asystem comprising: an apparatus for positioning a medical object, theapparatus comprising: a moving apparatus operable to robotically movethe medical object, wherein the medical object comprises a predefinedsection, wherein the predefined section is at least partially arrangedin an examination object, wherein the apparatus is configured to receivea control specification, wherein the moving apparatus is configured toposition the predefined section based on the control specification,wherein the apparatus is further configured to receive positioninginformation on the predefined section, determine a degree of deviation,the degree of deviation describing a deviation between the controlspecification and the positioning information, and determine acorrection specification for minimizing the deviation based on thedegree of deviation, and wherein the moving apparatus is furtherconfigured to reposition the predefined section based on the correctionspecification; and a capturing unit configured to: capture thepositioning, change in positioning, or the positioning and the change inpositioning of the predefined section in the examination object; anddetermine the positioning information based on the captured positioning,change in positioning, or positioning and change in positioning andprovide the positioning information to the apparatus.
 10. The system ofclaim 9, wherein the capturing unit includes a medical imaging devicethat is configured to record medical image data of the examinationobject, wherein the predefined section in the medical image data ismapped in a time-resolved manner, wherein the capturing unit isconfigured to capture the positioning, change in positioning, or thepositioning and the change in positioning of the predefined sectionbased on the medical image data.
 11. A method for providing a correctionspecification, the method comprising: receiving a control specificationby an apparatus for positioning a medical object, wherein the apparatuscomprises a moving apparatus operable for robotically moving the medicalobject, wherein the medical object comprises a predefined section,wherein the predefined section is at least partially arranged in anexamination object, wherein, prior to the start of the method, thepredefined section has been positioned by the moving apparatus based onthe control specification; receiving positioning information on thepredefined section of the medical object; determining a degree ofdeviation, wherein the degree of deviation describes a deviation betweenthe control specification and the positioning information; determiningthe correction specification for minimizing the deviation based on thedegree of deviation; and providing the correction specification.
 12. Themethod of claim 11, wherein the control specification includes aspecification for spatial positioning, the specification for spatialpositioning including a length dimension along the longitudinalextension direction of the medical object, an angle of the medicalobject with respect to the moving apparatus, a relative movement of themedical object with respect to the moving apparatus, or any combinationthereof, and wherein the positioning information includes information ona spatial positioning of the predefined section, the information on thespatial positioning of the predefined section including the lengthdimension along the longitudinal extension direction of the medicalobject, the angle of the medical object with respect to the movingapparatus, or a combination thereof.
 13. The method of claim 11, whereinthe control specification includes information on a direction ofmovement, wherein, prior to the start of the method, the predefinedsection has been positioned along the direction of movement by themoving apparatus, and wherein the degree of deviation is determined independence on the direction of movement.
 14. The method of claim 11,furthermore comprising: receiving a data set comprising a map, a model,or the map and the model of the examination object, wherein the degreeof deviation is determined based on the data set and the positioninginformation.
 15. The method of claim 14, wherein the data set comprisesa centerline model of a vascular section of the examination object,wherein the predefined section is arranged in the vascular section, andwherein the degree of deviation is determined with respect to thecenterline model.
 16. The method of claim 11, further comprising:receiving a further control specification by the apparatus, wherein,prior to the start of the method, the medical object has been moved bythe moving apparatus for positioning the predefined section in aninitial positioning along a first direction of movement based on thecontrol specification, wherein, prior to the start of the method, themedical object has been moved by the moving apparatus based on thefurther control specification against the first direction of movement,such that the predefined section comprises a deviation from an initialpositioning, and wherein the degree of deviation is determined based ona comparison of the control specification with the further controlspecification.
 17. The method of claim 16, further comprising: receivinga plurality of control specifications for different initial positioningsof the predefined section in the examination object, receiving theplurality of control specifications comprising receiving the controlspecification; and receiving a plurality of further controlspecifications for the initial positionings of the predefined section,receiving the plurality of further control specifications comprisingreceiving a further control specification, wherein the degree ofdeviation and the correction specification for the different initialpositionings in the examination object are determined, and wherein thecorrection specification for at least one further possible positioningof the predefined section in the examination object is determined byinterpolation, extrapolation, or interpolation and extrapolation of thecorrection specifications determined so far.
 18. The method of claim 11,wherein receiving positioning information comprises determining thepositioning information by applying a trained function to the controlspecification, and wherein at least one parameter of the trainedfunction is based on a comparison of training positioning informationwith comparison positioning information.
 19. The method of claim 11,further comprising: receiving medical image data from the examinationobject, wherein the predefined section in the medical image data ismapped in a time-resolved manner, and wherein the positioninginformation is determined based on the medical image data.
 20. A methodfor providing a trained function, the method comprising: receivingtraining control specifications by an apparatus for positioning amedical object; receiving, in each case, comparison positioninginformation for each of the training control specifications for apredefined section of the medical object, wherein the medical object isarranged in an examination object; determining training positioninginformation, the determining of the training positioning informationcomprising applying the trained function to the training controlspecifications; adjusting at least one parameter of the trained functionbased on a comparison of the training positioning information with thecomparison positioning information; and providing the trained function.